Latest / Morning Medical with Dr. Chow / Hypertension Awareness, Moderna's Updated Vaccine, and Trampoline Safety Guidelines

Transcript

Hypertension Awareness, Moderna's Updated Vaccine, and Trampoline Safety Guidelines · Morning Medical with Dr. Chow

• 0:00
  Good morning and welcome to another episode of Morning Medical with Dr.
• 0:05
  Chow.
• 0:06
  I'm your host, Dr.
• 0:07
  Chi-Ming Chow, and today we're diving into some alarming statistics about hypertension in the
• 0:13
  United States.
• 0:15
  A recent study published in JAMA Network Open has shown that more than half of U.S.
• 0:20
  adults with uncontrolled hypertension are unaware they have the condition.
• 0:25
  This is a staggering revelation, especially considering the severe health risks associated
• 0:31
  with uncontrolled hypertension.
• 0:36
  The study, led by Adam Vaughan, PhD, MPH, from the Division for Heart Disease and Stroke
• 0:42
  Prevention at the Centers for Disease Control and Prevention, examined the hypertension
• 0:47
  control cascade among U.S.
• 0:50
  adults with uncontrolled hypertension.
• 0:54
  The cascade includes awareness of hypertension, treatment recommendations, and the use of
• 0:59
  antihypertensive medication.
• 1:01
  By examining these factors, the researchers aimed to pinpoint where interventions could be
• 1:06
  most effective in improving hypertension control in the United States.
• 1:10
  One of the most striking findings from the study was that over 50 percent of adults with
• 1:15
  uncontrolled hypertension were unaware of their condition.
• 1:19
  This lack of awareness was particularly pronounced among younger adults aged 18 to 44,
• 1:25
  where a staggering 93 percent were unaware they had hypertension.
• 1:30
  This age group is often considered at lower risk for hypertension, but the findings suggest
• 1:35
  that they should not be overlooked in hypertension screening and education efforts.
• 1:41
  Another concerning finding was related to the use of blood pressure medication.
• 1:47
  Among the adults with uncontrolled hypertension, more than two-thirds were aware
• 1:52
  of their condition and were taking medication but still did not have their hypertension under
• 1:58
  control.
• 2:00
  This raises questions about the effectiveness of current treatment strategies and highlights
• 2:06
  the need for healthcare providers to ensure accurate blood pressure measurements,
• 2:11
  appropriate medication dosages, and patient adherence to treatment plans.
• 2:18
  The study also identified significant opportunities for healthcare providers to
• 2:23
  engage with patients who have uncontrolled hypertension.
• 2:27
  Many of these patients had multiple visits with healthcare providers in the past year but still
• 2:33
  did not achieve controlled hypertension.
• 2:36
  This indicates that there are multiple touchpoints where healthcare providers can
• 2:41
  intervene to improve hypertension management.
• 2:44
  Ensuring accurate blood pressure measurements, encouraging medication adherence, assisting
• 2:50
  with self-monitoring, and regular follow-ups are crucial steps in this process.
• 2:56
  Dr.
• 2:57
  Vaughan emphasized the importance of discussing hypertension with healthcare providers, even
• 3:03
  for those who are young or feel healthy.
• 3:06
  Early diagnosis and appropriate treatment are key to managing hypertension and preventing its
• 3:12
  associated risks, such as heart disease and stroke.
• 3:16
  The study's findings underscore the need for heightened awareness and proactive management
• 3:21
  of hypertension across all age groups.
• 3:25
  To put the numbers into perspective, 57.8 million adults in the United States are unaware
• 3:32
  that they have hypertension.
• 3:34
  Among the 35 million adults who are aware of their condition and are eligible for treatment,
• 3:39
  71 percent – which corresponds to 24.8 million Americans – are taking medication but still
• 3:46
  have uncontrolled hypertension.
• 3:48
  These figures highlight the immense opportunities to address hypertension control
• 3:53
  and reduce the burden of cardiovascular disease in the country.
• 3:57
  So, what can we take away from this study?
• 4:00
  First, it is crucial to raise awareness about hypertension, especially among younger adults
• 4:06
  who may not realize they are at risk.
• 4:08
  Second, healthcare providers need to ensure they are accurately diagnosing and effectively
• 4:14
  treating hypertension.
• 4:15
  And third, patients should be encouraged to actively engage in their treatment plans,
• 4:21
  including regular monitoring and follow-ups with their healthcare providers.
• 4:26
  In a significant development for the upcoming fall and winter immunization campaigns, Health
• 4:32
  Canada has authorized Moderna's updated COVID-19 vaccine.
• 4:36
  This new vaccine specifically targets the KP.2 variant, one of the latest offshoots of the
• 4:42
  Omicron variant.
• 4:44
  The authorization, which was announced on Tuesday, marks a crucial step in the ongoing
• 4:49
  effort to protect Canadians from severe hospitalizations and deaths related to
• 4:53
  COVID-19.
• 4:55
  The federal vaccine portal lists the approval of Moderna's updated product, and provinces and
• 5:01
  territories have already started planning their fall immunization campaigns.
• 5:07
  The National Advisory Committee on Immunization, or NACI, has strongly recommended
• 5:12
  the updated COVID-19 vaccinations starting this fall for high-risk groups.
• 5:17
  These groups include all adults aged sixty-five and older, people living in long-term care and
• 5:23
  other group settings, individuals with underlying medical conditions that increase
• 5:27
  their risk of severe illness, and members of First Nations, Métis, and Inuit communities.
• 5:34
  The recommendations also extend to racialized and other equity-deserving communities,
• 5:40
  pregnant individuals, and people who provide essential community services.
• 5:45
  For all other individuals aged six months and older, NACI has also recommended that they may
• 5:51
  receive the updated vaccine.
• 5:53
  A spokesperson for Moderna mentioned that the company would start delivering the product to
• 5:59
  the Public Health Agency of Canada within the next day or two.
• 6:03
  They expect a robust supply to be available in time for the provincial and territorial
• 6:08
  vaccination campaigns, though the specific timing will depend on each province's
• 6:12
  logistics.
• 6:14
  Dr.
• 6:15
  Fahad Razak, an internist at St.
• 6:17
  Michael's Hospital in Toronto, emphasized the importance of these fresh vaccines.
• 6:22
  He noted that the virus causing COVID-19 continues to mutate, making it crucial to have
• 6:28
  updated vaccines to ensure our immune systems can recognize and combat the virus effectively.
• 6:33
  Dr.
• 6:34
  Razak pointed out that the current number of Polymerase Chain Reaction tests coming back
• 6:39
  positive for COVID-19 in hospitals is at eighteen percent nationally, compared to four
• 6:44
  percent in April, indicating a significant rise in cases.
• 6:49
  Wastewater testing, often used as an early indicator of respiratory viruses, is also
• 6:55
  showing high levels of transmission, suggesting that we are currently experiencing a wave of
• 7:00
  infections.
• 7:02
  However, Dr.
• 7:03
  Razak noted that despite the rise in cases, we are not seeing a corresponding high number of
• 7:09
  hospitalizations.
• 7:10
  This highlights the importance of updated vaccines in preventing severe disease, even as
• 7:15
  the virus continues to circulate widely.
• 7:19
  Dr.
• 7:19
  Razak applauded Health Canada for shortening the approval window for the updated vaccine,
• 7:24
  emphasizing that rapid, updated vaccines will be essential for the foreseeable future.
• 7:30
  He also mentioned that Health Canada is expected to issue decisions on the updated
• 7:34
  Pfizer and Novavax COVID-19 vaccines in the coming weeks.
• 7:38
  According to Dr.
• 7:39
  Razak, the most critical factor is maintaining protection against severe disease, especially
• 7:45
  for high-risk groups who may not have received a vaccine during the spring immunization
• 7:49
  campaigns.
• 7:52
  Reducing infections is also vital, given the long-term health consequences that COVID-19 can
• 7:57
  have.
• 7:58
  Early research suggests that a concerning percentage of recovered COVID-19 patients have
• 8:04
  been left with chronic respiratory conditions like pulmonary fibrosis.
• 8:08
  Therefore, vaccinations to prevent severe illness, along with improving indoor air
• 8:13
  quality and taking steps to avoid exposing others when you are sick, are essential
• 8:18
  measures to mitigate the impact of the virus.
• 8:21
  In August, the federal government sent a notice to health professionals indicating that the
• 8:26
  previous COVID-19 vaccines targeting earlier variants would no longer be available.
• 8:32
  Health Canada stated that this decision is part of regulatory and supply management best
• 8:37
  practices, consistent with the approach to annual influenza vaccines.
• 8:41
  This move aims to ensure that the most effective and current vaccines are being
• 8:46
  administered to the public.
• 8:48
  In a move that has significant implications for the beverage industry, Health Canada has given
• 8:54
  manufacturers one year to remove brominated vegetable oil, or BVO, from their products.
• 9:01
  This decision follows a comprehensive safety assessment that concluded BVO should no longer
• 9:06
  be permitted as a food additive in Canada.
• 9:10
  Brominated vegetable oil is a stabilizing agent commonly used in citrus-flavored soft drinks to
• 9:16
  keep the flavor evenly distributed.
• 9:18
  Health Canada’s updated safety analysis, completed on August 30, did not find an
• 9:24
  immediate health concern with the current permitted use of BVO.
• 9:28
  However, the agency determined that the long-term safety risks warrant its removal from
• 9:32
  the market.
• 9:34
  Health Canada is allowing a one-year transition period, ending on August 30, 2025, to enable
• 9:41
  companies to reformulate and relabel their products.
• 9:45
  Until then, a maximum BVO level of 15 parts per million will continue to be permitted.
• 9:52
  This transition period is designed to minimize disruption and give manufacturers time to find
• 9:58
  suitable alternatives.
• 10:00
  This decision aligns Canada with other countries like the United States, which banned
• 10:04
  BVO in July, and regions like the United Kingdom, Europe, Australia, and New Zealand,
• 10:10
  where its use is already prohibited.
• 10:12
  The global trend away from BVO highlights growing concerns about its safety and the need
• 10:17
  for safer food additives.
• 10:20
  So, what exactly is BVO?
• 10:23
  According to the United States Food and Drug Administration, BVO is a vegetable oil used in
• 10:28
  small amounts to stabilize fruit flavoring in drinks.
• 10:32
  It helps keep the citrus flavoring evenly mixed, preventing it from floating to the top.
• 10:38
  In some cases, BVO is listed as brominated soybean oil on ingredient labels.
• 10:44
  While several major beverage companies, such as PepsiCo and Coca-Cola, have already phased out
• 10:50
  BVO from their products, it can still be found in others.
• 10:53
  For instance, Sun Drop citrus sodas by Keurig Dr Pepper and Walmart’s Great Value orange soda
• 11:00
  both list brominated soybean oil as an ingredient.
• 11:04
  The concerns about BVO stem from animal studies suggesting it could have adverse health effects
• 11:11
  on humans.
• 11:12
  Previous laboratory studies reported adverse effects on organs like the liver, heart, and
• 11:18
  thyroid at doses higher than what humans would typically consume from beverages.
• 11:24
  However, more recent research, including a 2022 study by the United States Food and Drug
• 11:30
  Administration and the National Institutes of Health, indicated that even lower doses could
• 11:36
  negatively impact the thyroid gland.
• 11:40
  The thyroid gland plays a crucial role in regulating the body's metabolism through
• 11:45
  hormone production.
• 11:46
  Excessive accumulation of BVO in the body could lead to bromine toxicity, causing symptoms such
• 11:52
  as headaches, nausea, memory loss, and loss of coordination.
• 11:57
  These potential health risks underscore the importance of removing BVO from the market.
• 12:03
  So, what are the alternatives to BVO?
• 12:06
  Health Canada has identified several potential substitutes, including sucrose acetate
• 12:12
  isobutyrate, glycerol ester of wood rosin, modified cellulose, acacia gum, and locust bean
• 12:19
  gum.
• 12:20
  These alternatives are expected to be safer and equally effective in stabilizing flavoring in
• 12:25
  beverages.
• 12:27
  Consumers can avoid BVO by checking ingredient labels on beverages, especially those with
• 12:33
  citrus or spruce oils.
• 12:35
  While the transition period allows for its continued use until next year, being vigilant
• 12:40
  about ingredient labels can help consumers make informed choices.
• 12:45
  This move by Health Canada is a significant step in ensuring the safety of food additives
• 12:51
  in the country.
• 12:53
  As the beverage industry adapts to these changes, consumers can look forward to safer
• 12:57
  alternatives in their favorite drinks.
• 13:01
  A TikTok trend could pose a potential hazard to children.
• 13:04
  "Glass fruit," otherwise known as Tanghulu—which involves hardening sugar over
• 13:09
  various fruits to give it a crunchy topping—has become a growing food trend on social media.
• 13:15
  Making Tanghulu requires microwaving a sugar and water mixture at 30-second intervals for
• 13:20
  about five minutes until it’s boiling, according to TikToker Jasmine and Tea, who
• 13:24
  posted a tutorial in April.
• 13:27
  The food-focused content creator warned in the video, which now has nearly 20 million views,
• 13:33
  that the mixture will get "really hot" and that people should not touch it with bare hands.
• 13:39
  The skewered fruit of choice is dipped into the liquid mixture while it’s still hot and placed
• 13:44
  on the side to harden.
• 13:47
  The viral trend has resulted in trips to the hospital for some children testing out the
• 13:51
  recipe at home.
• 13:53
  Shriners Children’s Hospital in Boston released a notice in August about an uptick in cases of
• 13:59
  children with severe burn injuries due to spilling sugar.
• 14:04
  Shriners surgeon Colleen Ryan, MD, reported that she has treated two patients within two
• 14:09
  weeks who were injured during the activity.
• 14:12
  "When sugar is melted in the microwave like this, it has a high heat capacity, meaning it
• 14:17
  stores the heat energy," she said in a statement.
• 14:20
  "If spilled, it can create a severe scald burn, much like spilling hot soup, but it can cause a
• 14:25
  much deeper burn because of sugar’s properties.
• 14:28
  Kids or teens can quickly grab the pot or bowl, and the hot fluid splashes, spills or splatters
• 14:34
  over them."
• 14:35
  Tanghulu is a traditional northern Chinese snack of candied fruit on a skewer.
• 14:41
  The result is "one or several small but very deep burns, often in critical areas such as the
• 14:47
  hand or the face," Ryan noted.
• 14:49
  "Parents should make sure their children have learned proper cooking safety and take
• 14:53
  preventive measures."
• 14:55
  The surgeon said that her colleagues, both in the United States and internationally, have
• 15:00
  also reported an increase in these injuries related to the cooking trend.
• 15:05
  She encouraged parents to be aware that their children might come across this trend on social
• 15:09
  media.
• 15:10
  "It can seem like a fun, harmless activity for kids to try making the treat themselves," she
• 15:15
  said.
• 15:16
  "There is an opportunity to prevent this injury if everyone is aware of this danger."
• 15:22
  Dr.
• 15:22
  Marc Siegel, senior medical analyst for Fox News and clinical professor of medicine at New
• 15:27
  York University Langone Medical Center, told Fox News Digital that melted sugar is
• 15:32
  "dangerous," and warned of how "contagious" these types of viral trends can be among kids.
• 15:39
  "Parents should be careful and make sure their children have learned proper cooking safety and
• 15:43
  take preventive measures," warned Shriners Children's Hospital in Boston.
• 15:49
  If a child gets burned, the doctor advises parents to remove their clothes from the
• 15:53
  affected area and wash with cool water.
• 15:56
  Shriners says not to apply ice to the burn and to seek medical attention if necessary.
• 16:02
  "Blistering is a second-degree burn and may respond to burn creams, but leathery (black,
• 16:08
  brown or white in color) may be third-degree and needs to be seen right away," Siegel added.
• 16:14
  Our final topic today is one that many parents might find surprising: the safety of
• 16:19
  trampolines for kids.
• 16:21
  With so many parents wanting their children to get more exercise, a backyard trampoline might
• 16:25
  seem like a good option.
• 16:27
  However, according to the American Academy of Pediatrics, the home use of trampolines is
• 16:32
  strongly discouraged.
• 16:35
  The American Academy of Pediatrics cites additional data about catastrophic injuries,
• 16:40
  including those that involve the spinal cord and result in permanent neurological damage.
• 16:47
  Safety considerations are important as kids play sports for their mental and physical
• 16:52
  health, but trampolines pose significant risks.
• 16:56
  Home trampoline use remains popular, and as a parent, I know that plenty of playdates and
• 17:01
  parties occur in commercial venues with trampolines.
• 17:05
  But what else should families know about trampoline use?
• 17:08
  How dangerous is it really?
• 17:10
  What injuries can occur, and which kids are especially vulnerable?
• 17:14
  Is it safer to use a trampoline in someone’s home or go to a commercial venue?
• 17:19
  And are there certain precautions that can make trampolining safer?
• 17:24
  To help with these questions, I spoke with CNN wellness expert Dr.
• 17:27
  Leana Wen.
• 17:28
  Dr.
• 17:29
  Wen is an emergency physician and clinical associate professor at George Washington
• 17:33
  University.
• 17:34
  She previously was Baltimore’s health commissioner and is the mother of two
• 17:38
  school-age children.
• 17:40
  Dr.
• 17:40
  Wen shared some eye-opening statistics.
• 17:43
  There were over 800,000 reported injuries associated with trampolines between 2009 and
• 17:50
  2018, according to a 2022 study published in the journal Pediatric Emergency Care.
• 17:57
  More than 36,000 of those cases resulted in hospital admission.
• 18:02
  More than one-third of injuries involved bone fractures.
• 18:05
  The most common injury sites were the arms and legs, though more than one in five children
• 18:10
  suffered head and neck injuries, including concussions.
• 18:13
  Children also suffered a variety of other injuries, such as damage to internal organs.
• 18:19
  There are a lot of ways kids can get hurt on trampolines.
• 18:22
  Children collide with one another while jumping at the same time.
• 18:26
  They can land wrong on the trampoline, which is especially dangerous if they are trying
• 18:30
  maneuvers such as somersaults or flips.
• 18:33
  If the trampoline is elevated, kids can fall off the trampoline and onto the ground.
• 18:39
  They can hit the springs or the frame.
• 18:42
  If there are multiple jumpers at once, one jumper can land and send another into the air,
• 18:47
  who could crash into someone else.
• 18:50
  The American Academy of Pediatrics issued a statement in 2012 strongly recommending against
• 18:56
  the use of recreational trampolines in kids.
• 18:59
  The academy reaffirmed this in 2020, citing the frequency of injury as well as the possibility
• 19:05
  of severe, irreversible injury, notably permanent neurological damage from injuries to
• 19:11
  the head and neck.
• 19:13
  Dr.
• 19:13
  Wen pointed out that jumpers on the same apparatus increase the risk of injury,
• 19:19
  especially for the smallest individuals.
• 19:22
  This is why pediatricians recommend that if you’re going to use a trampoline, its use
• 19:28
  should be restricted to a single jumper on the mat at one time.
• 19:34
  Research has shown that children five years and younger are at increased risk of fractures and
• 19:39
  dislocations due to trampoline-related injuries.
• 19:43
  The American Academy of Pediatrics strongly recommends against children younger than six
• 19:48
  years jumping on any trampolines.
• 19:51
  Moreover, some maneuvers, such as flips and somersaults, are especially associated with
• 19:57
  risk of head and cervical spine injury.
• 19:59
  These moves should be avoided in recreational settings.
• 20:04
  If children are learning trampolining as part of a structured sports program, parents must
• 20:09
  ensure there is specific coaching to develop the skill.
• 20:13
  Contrary to popular belief, having padding and enclosing the trampoline space may not prevent
• 20:18
  large numbers of injuries and may provide a false sense of security.
• 20:23
  Padding and netting can help, but they should be in good condition.
• 20:27
  The trampoline should also be set on the ground as falls off the trampoline can also cause
• 20:31
  injury.
• 20:33
  When it comes to trampoline use in someone’s house versus a commercial venue, Dr.
• 20:37
  Wen stated that both carry risks.
• 20:40
  One meta-analysis, published in 2020, found that injuries occurring at trampoline parks
• 20:45
  carried double the risk of requiring surgery compared with home trampoline use.
• 20:50
  The report also found that injuries from full-size trampolines had a six times higher
• 20:55
  risk of requiring surgery compared with injuries from mini-size trampolines.
• 21:01
  Another study, published in the journal Pediatrics in 2023, reported that 11 percent of
• 21:07
  injuries sustained at trampoline parks were significant.
• 21:10
  Overall, injuries occurred at a rate of 1.14 injuries per 1,000 jumper hours in the parks.
• 21:18
  Other research suggests that the rise in trampoline injuries can be attributed to the
• 21:23
  rising popularity of these commercial venues.
• 21:27
  That’s because trampoline parks are often crowded, with multiple jumpers at once.
• 21:32
  The commercial equipment could also allow jumpers to jump higher and therefore fall from
• 21:37
  greater heights and with greater force, leading to more injuries.
• 21:43
  Dr.
• 21:43
  Wen noted that there could be a false sense of security; parents may think that trampolines in
• 21:48
  a facility are safer than trampolines at home, and they may take comfort in thinking that
• 21:53
  there are lots of other adults there.
• 21:55
  However, they should carefully read the disclosure statements of these facilities, as
• 21:59
  these commercial venues certainly understand the possibility of injury.
• 22:04
  So, what can parents and guardians do to make trampolining safer?
• 22:08
  Dr.
• 22:09
  Wen recommends looking at the apparatus before letting your child use it.
• 22:14
  It’s best if the bouncing surface is as close to the ground as possible and not close to
• 22:19
  other objects, such as trees and walls.
• 22:22
  Look out for worn nets and pads and hooks and springs that are sticking out.
• 22:28
  If you’re going to a trampoline park, try to avoid busy times of the day to reduce the risk
• 22:33
  of collision.
• 22:34
  Stay close to your child and instruct them not to try dangerous maneuvers like flips.
• 22:40
  If they really want to learn gymnastics moves, they should join structured sports programs
• 22:45
  where they can learn them under close supervision.
• 22:48
  Watch out for small kids in particular.
• 22:51
  Kids younger than six years old really should not be using trampolines.
• 22:56
  And if you have a trampoline in your home, make sure to check your homeowners insurance prior
• 23:02
  to inviting other people over, as many policies will not cover guests if they get hurt on
• 23:07
  trampolines.
• 23:09
  Knowing all this, would Dr.
• 23:11
  Wen let her kids use trampolines?
• 23:14
  She says she’s treated enough patients with injuries from trampolines to understand their
• 23:18
  dangers.
• 23:19
  At the same time, she acknowledges that it’s hard to avoid trampolines altogether, given how
• 23:24
  popular they are.
• 23:26
  For her family, they’ve taken a harm-reduction approach—understanding that recreational
• 23:32
  trampoline use can be dangerous, they are reducing the harm by minimizing the frequency
• 23:37
  and reducing the highest-risk activities.
• 23:39
  Dr.
• 23:40
  Wen’s family doesn’t have a trampoline at home, and they try not to have playdates at homes
• 23:46
  with trampolines.
• 23:47
  If their kids do go to a home that has trampolines, they try to steer them away from
• 23:52
  it.
• 23:53
  If the kids really want to try it, they will watch them the entire time and have them jump
• 23:57
  one at a time.
• 23:59
  The one instance that’s harder to avoid is when their kids are invited to a birthday party at a
• 24:04
  commercial venue with trampolines.
• 24:06
  It’s hard to ask kids to miss out on their best friends’ parties.
• 24:10
  In these cases, they set rules in advance—no somersaults, stay within eyesight of a parent,
• 24:15
  and leave the jumping area if there are much bigger kids in the same space.
• 24:20
  Other parents will have different risk-tolerance levels.
• 24:24
  The key is to understand the risks so that each family can make their own evaluation and reduce
• 24:29
  risk when possible.
• 24:32
  That wraps up today’s episode of Morning Medical with Dr.
• 24:35
  Chow.
• 24:35
  I hope you found our discussions on hypertension, the updated COVID-19 vaccines,
• 24:40
  the removal of brominated vegetable oil from drinks, the dangers of the TikTok Tanghulu
• 24:45
  trend, and trampoline safety to be informative and helpful.
• 24:48
  Stay safe, stay healthy, and I’ll see you tomorrow for another episode.
• 24:52
  Thank you for listening.